Social factors, life course

The field of social epidemiology aims to relate the health status of the individuals to their life course rather than their social situation observed at one point in time. Social inequalities in health are considered as the outcome of a process constructed by someone’s experiences, cumulated over the years. In that sense, the social groups are built on the basis of proxy variables (education, income, occupation) and are not so homogeneous as regards to their members experiences and exposures. In that respect, analysis of social inequalities in health should rather explore pathways and cumulated risks from the early exposures in childhood through the adulthood living and working conditions, to the late ages.

Social inequalities in life expectancy

I work on the social inequalities in mortality in the line of the demographic studies conducted for 50 years at INSEE. Based on pinpoint information from the public statistics (Echantillon Démographique Permanent), I calulculated life tables and differential mortality estimates. The studies showed the persisting inequalities in France, below and above age 65 and over time. They also demonstrate the variation in the estimates based on education or occupation. They also reaffirmed the interest a dynamic approach, considering trajectories rather than situations.

Selection of publications:

  • Cambois, E., and C. Laborde. 2011. Mobilité socioprofessionnelle et mortalité en France : des liens qui se confirment pour les hommes et qui s’affirment pour les femmes. Population.
  • Dalstra, J.A., A.E. Kunst, C. Borrell, E. Breeze, E. Cambois, G. Costa, J.J. Geurts, E. Lahelma, H. Van Oyen, N.K. Rasmussen, E. Regidor, T. Spadea, and J.P. Mackenbach. 2005. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol 34: 316-26.
  • Mackenbach, J.P., P. Martikainen, C.W.N. Looman, J.A.A. Dalstra, A.E. Kunst, E. Lahelma, and members of the SEdHA working group. 2005. The shape of the relationship between income and self-assessed health: an international study. Int J Epidemiol 34: 286-93.
  • Cambois, E., and F. Jusot. 2007. Ampleur, tendance et causes des inégalités sociales de santé et de mortalité en Europe: une revue des études comparatives. Bulletin épidémiologique hebdomadaire 2/3: 10-4.
  • Cambois, E. 2004. Occupational and educational mortality differentials: magnitude and trends over last decades. Demographic ResearchSp Coll 2:278-304. 
  • Cambois, E. 2004. Careers and mortality: Evidences on how far occupational mobility predicts differentiated risks. Social science and medicine 58: 2545-58.

The double disadvantage of the manual workers

We demonstrated the size of the inequalities in health expectancies and a double disadvantage for the manual workers. They have a shorter life expectancy, but a larger number of years to be lived with disability and poor health within this shorter life. Such inequalities persists after the retirement, but they exist long before resulting in unequal chance of reaching the age of retirement in good health.

Selection of publications:

  • Cambois, E., C. Laborde, I. Romieu, and J.-M. Robine. 2011. Occupational inequalities in health expectancies in France in the early 2000s: Unequal chances of reaching and living retirement in good health. Demographic Research 25: 407-36.
  • Cambois, E., and J.-M. Robine. 2011. Pour qui la retraite sonnera ? Les inégalités d’espérance de vie en santé avant et après 65 ans. Bulletin épidémiologique hebdomadaire 8-9: 82-6.
  • Robine, Jean-Marie and Emmanuelle Cambois (Ed). 2010. "La Santé Des Travailleurs Âgés." Pp. 263 in Retraite et Société. Paris: CNAV.
  • Cambois, Emmanuelle, Thomas Barnay and Jean-Marie Robine. 2010. "Espérances De Vie, Espérances De Vie En Santé Et Âges De Départ À La Retraite : Des Inégalités Selon La Profession En France." Retraite et Société (59):194-204.
  • Cambois, E., C. Laborde, and J.-M. Robine. 2008. La "double peine" des ouvriers : plus d’années d’incapacité au sein d’une vie plus courte. Population et sociétés: 1-4.
  • Cambois, E., and J.-M. Robine. 2004. Problèmes fonctionnels et incapacités chez les plus de 55 ans : des différences marquées selon les professions et le milieu social. Etudes et résultats 295: 1-8.
  • Cambois, Emmanuelle, Jean-Marie Robine and M Hayward. 2001. "Social Inequalities in Disability-Free Life Expectancy in the French Male Population (1980-1991)." Demography 38(4): 513-24.

Past experiences and health

A set of question on past adverse experiences that I proposed for measuring the long term impact of early circunstances was introduced in a French health survey ESPS (2004). Past adverse experiences are reported by 20% of the population and are significantly associated with poor health above the current social situation. Focussing on the population with the highest income at the time of the survey, these past experiences (reported by 10% of them) increased the prevalence of poor self-rated health but not the risk of disability (when accounting for the health status).

Selection of publications:

  • Cambois, E., and F. Jusot. 2010. Contribution of lifelong adverse experiences to health inequalities in France: evidence from a population survey. Eur J Public Health.(doi: 10.1093/eurpub/ckq119)
  • Cambois, E. 2004.Les personnes en situation sociale difficile et leur santé. In Les travaux de l’Observatoire national de la pauvreté et de l’exclusion sociale 2003-2004, edited by ONPES, 101-26. Paris: La Documentation Française.